EMS transport costs clarified

July 24, 2013

I have been honored to serve as District 2 Lee County Commissioner and Board Chairman during the past eight months. On my first day in office, I participated in a unanimous vote to privatize MedStar, which saved Lee County millions of dollars in taxes and fines. As promised, each and every decision I make is based on the best interests of all Lee County residents and visitors and I will continue this effort.

Lee County EMS transported more than 58,000 patients last year. As many of you know, we strive to provide the best patient care. Our mobile computers and heart monitors were recently upgraded to provide state-of-the-art, field-to-hospital communication. Lee County EMTs and Paramedics receive constant training and are reviewed by a rigorous quality assurance and improvement process. While quality care is paramount, it is also the county's duty to find every efficiency available because I also have a fiduciary responsibility to every Lee County citizen.

I believe a significant amount of misinformation was recently presented in the community. I would like to offer clarification:

Recent requests from Bonita Springs Fire and Rescue District to allow it to provide EMS transport have been denied because allowing that request would fracture a highly coordinated system without consideration of cost effectiveness. Using projections from existing budgets, the cost for BSFD to provide EMS transport would be seven times more expensive than for the county to provide the service. The current per capita expenditure for Lee County's EMS service is $44.36 and the per capita expenditure for BSFD would be $328.12.

The BSFD's claim that the county will be losing money by allowing Lee Memorial to contract with Ambitrans for its own inter-facility hospital-to-hospital transports is incorrect. BSFD has no experience with billing and collections since it has never had the responsibility of transporting patients. First, Lee County EMS was only breaking even with the revenue from performing inter-facility transports. By transferring those resources previously dedicated to inter-facility transports back to our core service, pre-hospital emergency response, Lee County is receiving revenue from patient transports. Second, the Medicare/Medicaid reimbursement rates change with the Affordable Health Care Act so Lee County would lose money by continuing to perform inter-facility transports in the future. That's why we are working so closely with Lee Memorial to find efficiencies yet still provide quality care.

As Board Chairman, it is my responsibility to ensure that all of our citizens are receiving the best service through the most efficient means while preventing tax increases and duplication of services. This includes the residents of Bonita Springs, where the BSFD millage rate has gone up twice within the last five years, and it is currently proposed for another increase. I understand what the BSFD is asking, and I truly appreciate all of our public safety employees from each fire district for their dedication. It is my obligation however to look at issues from a countywide perspective and weigh the fiscal prudence and safety for all Lee County citizens.

-- Cecil L. Pendergrass is Chairman of the Lee County Board of County Commissioners